Stanley Feld M.D. FACP,MACE
Dear President-elect Trump,
The medical student, Jacob Chevlen, got it right.
“Don’t call me a provider.”
President-elect Trump, if you really want to repair the healthcare system and I believe you do, you must listen to this medical student carefully.
You must realized that patients are not commodities. They are living human beings with emotions as well as concrete illnesses.
Many illnesses and their complications can be avoided if the way to maintain good health is understood by consumers. Cultural changes must occur to decrease the external stimuli that lead to these illnesses including obesity and drug abuse.
It must be recognized that the most important stakeholders in the healthcare system are patients (consumers). A viable healthcare system must be built around patients who have incentives to remain healthy.
Consumers of healthcare depend on physicians. Physicians are the second most important stakeholders in the healthcare system.
Patients depend on physicians to use their expertise and judgment to help them maintain health and to fix them when they get sick. This skill is developed over 6 to 10 years of post-graduate education.
The government, the healthcare insurance companies, the hospital systems, and the pharmaceutical companies are all secondary stakeholders.
Both patients (consumers) and physicians have been devalued by the government’s desire to simply reduce healthcare costs.
Government bureaucracies believe that they can reduce costs by regulating physicians’ “decision making” and “second guess” their clinical judgment.
The federal government is trying to control the healthcare system. The harder the government tries to control the healthcare system the more dysfunctional it becomes.
Some day the federal government is going to realize it costs more in the long run to try to control the two most important stakeholders. (consumers and physicians) than it is to provide financial incentives to consumers to maintain their health.
Society has been programed by government and other secondary stakeholders to consider physicians as healthcare providers.
We are not healthcare providers. We are physicians! Medical student Jacob Chevlen expresses this sentiment perfectly.
“I am a medical school student. Like many of you reading this, my life is spent between the walls of the library and the walls of the clinic.”
I remember being told as a first year medical student that I would have to learn a new language and live a different life than my college friends not going into medicine.
“I was told at the beginning of this journey that it was fair; that it was an “equivalent exchange.”
"You want to relieve suffering — great — you’re going to suffer."
"You want to extend lives — fantastic — you’ll trade years of your own."
"You want to lead your patients to healthier relationships — beautiful — I promise you’ll be distanced from your family, friends, and other loved ones.”
One of these statements with its consequences has been true for many physicians I have known through the years.
“We accepted this trade because we are driven to be physicians.”
“Ultimately, it’s a small price to pay to join that sacred society of men and women who devote their lives to healing.”
It is truly a fulfilling emotional experience to have practiced clinical endocrinology for 30 years. I have developed so many wonderful physicians/patient relationships. I know these relationships that I had added to my therapy. These relationships had immensely improved my patients’ treatment outcomes and well-being.
“However, none of us made these sacrifices to be a “provider,” and this is the culture we must fight.”
As President of AACE and subsequent author of Repairing the Healthcare System, I have tried to fight for a cultural change.
Obamacare has devalued physicians and downgraded the physician/patient relationship.
Some of these sick human beings have no interest in listening to a provider when the government or the health insurance company will take care of them when they get sicker.
Consumers who desire to develop a patient/physician relationship are finding they have access. So many physicians have given up on developing physician/patient relationships.
Consumers are now gravitating to concierge physicians in their quest to find a physician that cares and will develop a physician /patient relationship with them.
“Recently, the director of the Governor’s Office of Health Transformation spoke at my medical school.”
It sounds like an agency in Atlas Shrugged to me. The “GOHT” is a mind programing agency whose goal is to manipulate physicians’ minds.
“To enroll in that will give them enhanced reimbursement for reducing costs to Medicaid.”
“Not once during his entire lecture did he use the word “doctor”, when referring to physicians, or advanced practice nurses; he only referred to them as “healthcare providers.”
The “experts” believe that social engineering works. President-elect, you surprised the government, the media and the experts and showed them social engineering does not work. You won the election, didn’t you?
Jacob Chevlan goes on to say;
Have you ever considered what a “provider” is or does?”
“Well, that’s obvious: A provider provides! A provider is the source of a good or service. They disseminate it freely and happily, expecting nothing in return.”
Unimportant is the many years of schooling to develop an understanding of the subtleties of disease, its presentation and treatments.
Physicians’ judgment and patient physician relationships should not be discounted.
“That is how government, insurance companies, and hospitals look at physicians. We are obliging tools, conduits along the path of the flow of money from patients to insurance companies, and insurance companies to hospital systems.”
Medical Student Jacob Chevlan has nailed it President-elect Trump. If you have any chance of Repairing the Healthcare System you should listen to this medical student who has not been involved in the present disillusionment of the practice of medicine.
“Our feelings, and our goal of providing top-level care, are fundamentally irrelevant.”
“ Why else would prior-authorizations exist?”
The government and the healthcare insurance industry’s data supersede physicians’judgment.
“Or electronic health records whose only real function is to facilitate billing?”
EMR’s as crafted can easily provide irrelevant false “big data.” EMR’s should be used as a continuing education tool to enhance physicians’ judgment rather than a punishment tool for physicians’ reimbursement.
“ Or the fact that it is illegal to provide pro-bono care to Medicaid or Medicare patients?”
“These and other “innovations” burden physicians and patients, slowing or even completely halting the delivery of care.”
This medical student goes on to say;
“I do not know when physicians allowed themselves to be called “providers,” but I do know that no positive change will happen to our toxic and unsustainable health care system until we stop accepting it.”
I can only hope Mr. President-elect that you take heed and listen to this medical student as your surrogates formulate your replacement for the disaster called Obamacare.
“I am not a “provider school” student. When I graduate, my diploma will not say “provider” on it. It will say “doctor,” and we should accept nothing less.”
Bravo Jacob Chevlan !!!
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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